JP6339681B2 - Position detection in intravascular imaging - Google Patents

Description

  The present disclosure relates to intravascular imaging systems and methods of operation thereof.

  Intravascular imaging is often used to identify diagnostically important properties of blood vessels. For example, an intravascular imaging system may be used by medical personnel to help identify and locate an obstruction or lesion within a blood vessel. Typical intravascular imaging systems include an intravascular ultrasound (IVUS) system as well as an optical coherence tomography (OCT) system.

  Intravascular imaging includes one or more transducers that emit and / or receive energy based on received electrical signals and return signals based on signals reflected by various intravascular structures. Send. Intravascular imaging is often used for image generation. In some examples, a console with a high resolution display can display intravascular images in real time. In this way, using intravascular imaging, in-vivo visualization of vascular structures and lumens, including coronary lumens, coronary artery wall morphology, and stents on or near coronary artery wall surfaces, in-vivo it can. Intravascular imaging may be used to visualize diseased blood vessels, including coronary artery disease. In some examples, the transducer can be carried near the tip of the intravascular imaging catheter. Some intravascular imaging systems rotate (mechanical, phased array, etc.) intravascular imaging catheters to visualize 360 degrees.

  Many intravascular imaging systems are configured to perform translational operations, in which case the imaging component of the catheter is translated within the patient's blood vessel during image acquisition. As a result, a 360 degree image with a longitudinal image element is obtained. When performing a translation operation, it may be important to accurately measure at least the relative translation of the imaging component of the catheter in order to accurately construct a 360 degree image.

  In existing systems, the amount of translation is often estimated by attempting to translate the catheter at a specific speed for a specific time. If the imaging component of the catheter is translated at a specific speed for a specific time, the translation distance can be calculated. However, if the actual translation speed is not the same as the commanded speed, or if it cannot be measured or generated with high reliability, the translation amount measurement will be inaccurate. If the measurement of the translation amount is unclear, errors can occur in the construction of a 360 degree image with longitudinal image elements.

  Embodiments of the intravascular imaging system discussed in this disclosure can detect the real-time position of the catheter transducer, which can result in a more accurate intravascular image with longitudinal image elements. Many intravascular imaging catheter embodiments include one or more transducers at the tip. The position sensor can include a reference element and a movable element, and the position of the movable element can be correlated with the position of the transducer. Since the position of the movable element and the transducer are correlated, the position of the transducer with respect to the position of the reference element can be determined from the position of the movable element with respect to the position of the reference element. In many embodiments, the intravascular imaging engine can generate a display based on such position information and image information received from the transducer. The intravascular imaging engine can receive image information associated with several movable element positions and can generate an intravascular image with longitudinal image elements (eg, in real time). The unique movable element position associated with each set of position and image information can be correlated with a unique transducer position within the patient's blood vessel.

  In various embodiments, position sensors can be placed at various locations in the intravascular imaging system. For example, the reference element and the movable element can be placed on a component of a translation mechanism that translates the catheter within the patient's blood vessel (eg, automatically or manually). In another example, the reference component can be placed in a reference medical component such as a surgical mat. In other examples, the reference element and the movable element can be placed on a catheter component. Many combinations and configurations are possible and are envisioned according to the spirit provided herein.

1 is an exemplary intravascular imaging system. 1 is a system level block diagram of an exemplary intravascular imaging system. FIG. FIG. 2 is a system level block diagram of an exemplary translation mechanism of some intravascular imaging systems. FIG. 2 is a perspective view of an exemplary translation mechanism of some intravascular imaging systems. FIG. 2 is a perspective view of an exemplary translation mechanism of some intravascular imaging systems. 2 is a side view of first and second telescopic portions of an exemplary intravascular imaging catheter. FIG. 2 is a side view of first and second telescopic portions of an exemplary intravascular imaging catheter. FIG. FIG. 6 is a step flow diagram of an exemplary method for generating one or more displays. An exemplary longitudinal image is shown.

  The following detailed description is exemplary in nature and is not intended to limit the scope, applicability, or configuration of the invention. Rather, the following description provides some examples for practicing the examples of the present invention. Examples of configurations, materials, dimensions, and manufacturing processes are provided for selected elements, all other elements utilizing what are known to those skilled in the art of the present invention. Those skilled in the art will recognize that there are a variety of suitable alternatives to many of the examples mentioned.

  FIG. 1 is an illustration of a system 100 that can be configured to perform intravascular imaging. System 100 may include a catheter 102, a translation mechanism 110, and an imaging engine 112. Catheter 102 may include a proximal end 104 and a distal end 106 configured to be inserted into a blood vessel of patient 118. As shown, the patient 118 is placed on an operating table that may include a surgical mat 119. In one example, the catheter 102 may be inserted into the patient 118 via the femoral artery and guided to a region of interest within the patient 118 body. A broken line in FIG. 1 shows a portion of the catheter 102 inside the patient 118.

  In some examples, the catheter 102 may include a transducer 108 within the tip 106, which images, for example, a region of interest within the body of the patient 118 so as to transmit and receive wave energy and generate image data. Configured to be For example, if the system 100 is an IVUS system, the transducer 108 may include an ultrasound transducer configured to transmit and receive ultrasound energy and generate ultrasound data. In other examples, the system 100 may be an OCT system and the transducer 108 may include an OCT transducer configured to transmit and receive light and generate OCT data. The catheter 102 can be configured to generate image information and transfer the image information for imaging.

  The translation mechanism 110 of the intravascular imaging system 100 can be engaged with the catheter 102 and can be configured to translate the catheter 102 within the body of the patient 118 by a controlled distance during pullback or other translational operations. In some embodiments, the translation mechanism 110 can function as an intermediary with the catheter 102. The translation mechanism 110 can translate all or part of the catheter 102 through the blood vessels of the patient 118. For example, in embodiments where the catheter includes a drive cable attached to a transducer 108 housed within the sheath, the translation mechanism 110 functions to translate the drive cable and transducer 108 within the sheath while the sheath remains fixed. it can.

  Imaging engine 112 may be in communication with transducer 108 and translation mechanism 110. According to some examples, the imaging engine 112 may include at least one programmable processor. In some examples, the imaging engine 112 may include a computer that receives commands from a user 116 of the system via the user interface 120 and / or displays data obtained from the catheter 102. One or more processors configured. The computer includes computer peripherals (eg, keyboard, mouse, electronic display) that receive input from the system user 116 and output system information and / or signals received from the catheter 102 (eg, rendered images). May be. User interface 120 may include a conventional PC or PC interface with software configured to communicate with other components of intravascular imaging system 100. In some embodiments, the user interface 120 may include a display 114 configured to display system information and / or imaging signals (eg, intravascular images) from the catheter 102. In some embodiments, the user interface 120 includes a touch screen display that can both receive commands from the user 116 of the system and display intravascular imaging data from the catheter 102. In some examples, the imaging engine 112 may include a memory module for storing instructions or software executable by one or more processors.

  FIG. 2 is a system level block diagram of an embodiment of an intravascular imaging system 100 that includes a position sensor 122. In particular, the exemplary system 100 of FIG. 2 includes a catheter 102, a position sensor 122, and an intravascular imaging engine 112. Catheter 102 can include a transducer 108 and can be in communication with an intravascular imaging engine 112. In some embodiments, intravascular imaging engine 112 is in direct communication with transducer 108. In the embodiment of FIG. 2, intravascular imaging engine 112 includes a display 114, a user interface 120, a memory / data storage 130, and a processor / controller 132. These components may be incorporated into a touch screen display and / or computer, for example.

  In some embodiments, the catheter 102 or the transducer 108 within the catheter 102 can be translated within the patient's blood vessel during the performance of the imaging function. In such a case, intravascular imaging engine 112 can receive image information from transducer 108 at multiple transducer locations. In some embodiments, the intravascular imaging engine 112 can receive image information from a plurality of transducer positions and construct a composite longitudinal image that includes image information from at least some subset of the plurality of transducer positions. In order to construct such a composite image, it may be beneficial for the intravascular imaging engine 112 to detect at least the relative relationship between the previous locations that received the image information. Accordingly, some embodiments of the intravascular imaging system 100 include a position sensor 122.

  The position sensor 122 shown in FIG. 2 may include a movable element 126 and a reference element 124. The position sensor 122 can include, for example, an electrometer, encoder, linear variable differential transformer, or other suitable position sensor. Such a position sensor 122 can be incorporated into the intravascular imaging system 100 and in communication with the intravascular imaging engine 112. The movable element 126 of the position sensor 122 can have a movable element position that correlates with the position of the transducer 108. The correlation between the transducer position and the position of the movable element 126 is shown in FIG. The reference element 124 of the position sensor 122 can be substantially fixed with respect to the movement of the transducer 108 during an intravascular imaging operation. In such embodiments, due to the correlation between the transducer position and the movable element position, the position sensor 122 can be configured to measure the relative motion of the transducer 108 relative to the reference element 124 of the position sensor 122. In some embodiments, the position sensor 122 can measure the relative motion of the transducer 108 with respect to the reference element 124, and the position sensor 122 can communicate this to other components of the intravascular imaging engine 112.

  As shown in FIG. 2, the position sensor 122 can be in communication with the intravascular imaging engine 112. In some embodiments, intravascular imaging engine 112 can be configured to receive position information from position sensor 122. The position information can include information about the position of the movable element 126 of the position sensor 122 relative to the reference element 124. The position information may include information received from the encoder, resistance information or other electrical data from the electrometer, or any other signal or information from various position sensors. In embodiments where the position sensor 122 measures relative movement of the transducer 108 relative to the reference element 124, the position sensor 122 can provide position information to the intravascular imaging engine 112. In some embodiments, the position sensor 122 can provide information about the movable element 126 and the reference element 124 to the intravascular imaging engine 112, which can measure the relative movement of the transducer 108 relative to the reference element 124. . As described above, the position of the movable element 126 can be correlated with the position of the transducer 108 of the catheter 102. In some embodiments, the position sensor 122 compares the position of the movable element 126 with that of the reference element 124, explains how the position of the movable element 126 is correlated to that of the transducer 108, and the position of the transducer 108. Can be measured with respect to that of the reference element 124. In such embodiments, the position sensor 122 can provide the position of the transducer 108 to the intravascular imaging engine 112. In some embodiments, the position sensor 122 can simply send information about the position of the movable element 126 relative to the position of the reference element 124 to the intravascular imaging engine 112. In some such embodiments, the intravascular imaging engine 112 compares the position of the movable element 126 with that of the reference element 124 and explains how the position of the movable element 126 is correlated to that of the transducer 108. , The position of the transducer 108 can be measured with respect to that of the reference element 124.

  In some embodiments, the intravascular imaging engine 112 can be configured to receive both image information from the intravascular imaging catheter 102 and position information from the position sensor 122. Intravascular imaging engine 112 may associate specific image information with the relative position of transducer 108. The intravascular imaging engine 112 can be configured to generate a display based on the image information and the position information.

  The intravascular imaging engine 112 can receive and process image information and position information corresponding to a plurality of positions in the long axis direction in the blood vessel to be imaged. In some embodiments, the intravascular imaging engine 112 can receive a first set of image information and a first set of position information, each corresponding to a first movable element position. In addition, the intravascular imaging engine can receive a second set of image information and a second set of position information, each corresponding to a second movable element position. In general, image information and position information can include information corresponding to any number of movable element positions. In some preferred embodiments, the intravascular imaging engine 112 can process image information and position information in real time for multiple positions during translation of the transducer and provide real-time imaging of the vessel being imaged.

  As described elsewhere herein, in some embodiments, the movable element position is correlated with the position of the transducer 108. Therefore, the first and second sets of image and position information corresponding to the first and second movable element positions can also correspond to the first and second transducer positions. The transducer 108 can be translated to various positions within the patient's blood vessel while the movable element 126 can correspondingly move relative to the reference element 124. The transducer 108 can be translated within the patient's blood vessel by a variety of methods. In some embodiments, the catheter 102 translates within the patient's blood vessel. The transducer 108 can be translated within the catheter 102, for example, in a sheath. In some embodiments, the intravascular imaging system can include a translation mechanism configured to translate the catheter 102 and / or the transducer 108 within the catheter 102.

  Some translation mechanisms may include an interface element configured to engage at least a portion of the catheter 102, and a translation element configured to engage and translate the interface element. it can. FIG. 3 is a system-level block diagram illustrating an exemplary translation mechanism 110 in an embodiment intravascular imaging system 100. The system 100 shown in FIG. 3 includes a catheter 102 having a transducer 108. The system 100 can further include an intravascular imaging engine 112 configured to receive image information from the catheter 102 and generate a display. In some embodiments, the system 100 includes a position sensor having a reference element 124 and a movable element 126, which is generally configured as described elsewhere in this disclosure. The position sensor provides position data to the intravascular imaging engine 112, which can use it to generate a display.

  In some embodiments, the system 100 can include a translation mechanism 110. The translation mechanism 110 can include a translation element 142 and a mediating element 140. In some embodiments, the translation element 142 is configured to translate the mediating element 140. Translation between the intermediate element 140 and the translation element can be achieved by a motor 158 incorporated in the translation mechanism 110. In some embodiments, the translation between the mediating element 140 and the translation element 142 can be performed manually by the user. The translation mechanism 110 can include a damping mechanism 160 for smooth translation.

  The mediating element 140 can provide a mechanical and / or electrical connection with the catheter 102. In some embodiments, the mediating element 140 can include a rotation mechanism 162 configured to rotate the transducer 108. The rotation of the transducer 108 can be performed to perform an imaging function. The mediating element 140 can be in communication with the intravascular imaging engine 112. The intravascular imaging engine 112 can transmit signals to the mediating element 140 that cause the transducer 108 to rotate via the rotating mechanism 162. In some embodiments, mediating element 140 provides a communication interface between intravascular imaging engine 112 and catheter 102 and / or transducer 108. Signals from the intravascular imaging engine 112 can be transmitted to the transducer 108 via an electrical connection between the catheter 102 and the mediating element 140.

  As described elsewhere in this disclosure, the relative movement of the position sensor movable element 126 and the reference element 142 can be measured. In some embodiments, the position sensor 122 can be incorporated into the translation mechanism 110. For example, the reference element 124 of the position sensor 122 can be secured to the translation element 142 of the translation mechanism 110, while the movable element 126 of the position sensor 122 can be secured to the mediating element 140 of the translation mechanism 110, or vice versa. .

  Thus, in some embodiments, the position sensor 122 can provide information regarding the relative position between the mediating element 140 and the translation element 142 of the translation mechanism 110. In some such embodiments, when the translating element 142 of the translating mechanism 110 is fixed with respect to the patient and the mediating element 140 is fixed to the transducer 108, the position sensor 122 is relative to the transducer 108 within the patient's body. Can provide information on The intravascular imaging engine 112 can receive data from the translation mechanism 110. Such data is generated by the transducer 108 and transmitted to the intravascular imaging engine 112 via the mediating element 140 and / or the intravascular imaging engine 12 via the position sensor 122 in the translation mechanism 110. The position information transmitted to the can be included.

  The translation mechanism 110 can include a motor 158 for translating the mediating element 140 relative to the translation element 142. The motor 158 can be a servo motor, a step motor, a linear induction motor, or other suitable motor. In some embodiments, intravascular imaging engine 112 can be in communication with motor 158. Communication can be established directly between the motor 158 and the engine 112. In some embodiments, communication can be established via translation mechanism 110. Intravascular imaging engine 112 may receive a command for translating mediating element 140 through motor 158 via a user interface.

  In some embodiments, translation by the motor can be automated by commands stored in a memory 130 that communicates with the intravascular imaging engine 112. That is, the translation mechanism 110 can be motorized for automatic translation. Automatic translation by the motor can be initiated by various events including, but not limited to, user prompts, pre-programmed motion sequences, and others. During automatic translation, the motor can translate the mediating element 140 by a predetermined distance with respect to the translation element 142. The relative position between the mediating element 140 and the translation element 142 can be determined from the position sensor 122 as described elsewhere herein. Thus, in some embodiments, intravascular imaging engine 112 can communicate with position sensor 122 and translation mechanism 110 to cause a predetermined translation of transducer 108. In some embodiments, securing the motor 158 directly to the catheter 102 or transducer 108 can cause the movement to take place without the need for separate translation elements 142 and / or mediation elements 140 of the translation mechanism 110. it can.

  A user can manually translate, for example, a portion of the catheter 102 and / or transducer 108 or a portion of the translation mechanism 110, such as the mediating element 140. Some operators prefer manual translation over automatic translation. In some examples, the operator evaluates the flexibility to see a particular region of interest in greater detail by manually moving the transducer 108 to a particular location. Measuring the position of the transducer 108 rather than predicting can be important in many instances where the transducer is translated by hand.

  In some embodiments, the translation mechanism 110 can include a damping mechanism configured to prevent abrupt movement of the transducer 108. The damping mechanism can smooth the translation of the transducer 108 by a spring-loaded mechanism, a hydraulic mechanism, or other suitable damping mechanism. By preventing sudden or sudden movement of the transducer 108 and / or catheter 102, the quality of the image produced by the system can be improved and unwanted sudden movement of components within the patient's body can be prevented.

  FIG. 4A shows the mediating element 140 engaged with the catheter 102 and secured to the translation element 142. In some embodiments, the mediating element 140 can be configured to translate with respect to the translation element 142. In operation, the mediating element 140 is secured to the catheter 102 at the attachment point 156 and can be translated with respect to the translation element 142, for example, via the track 150. The translating element 142 can be held stationary with respect to the patient so that when the mediating element 140 is translated with respect to the translating element 142, the mediating element 140 engages a portion of the catheter 102 and causes the transducer 108 to engage the patient's blood vessel. Translate within. In some embodiments, the translation element 142 determines the translation of the mediating element 140 with respect thereto. The translation can be caused by the control means 146, for example.

  FIG. 4B shows an exemplary translation element 142. The translation element 142 can include a display 144 and a control means 146 for a user to observe and manipulate the setting and operation of the translation mechanism and / or intravascular imaging system. In some embodiments, the control means 146 allows the user to control the operation of the intravascular imaging system. For example, in various embodiments, the user performs an imaging function, translates transducer 108 and / or catheter 102, rotates transducer 108, or other that the user can initiate via control means 146. Can perform any user function.

  Referring to FIGS. 4A-4B, the display 144 can display information regarding the intravascular imaging system. The display 144 can display information such as the relative position of the catheter 102 and / or transducer, the relative position of the reference and movable elements of the position sensor, the speed at which movement is taking place, or other related system parameters. In some embodiments, the display 144 can display a graphical user interface (GUI) that assists the user in operating the system via the control means 146. Thus, in various embodiments, a user can use a user interface on an intravascular imaging engine or a control means 146 and a display 144 on a translation mechanism, for example, to place a transducer on the motor in the user's blood vessel. Can be translated. As described above, in some embodiments, the user can manually translate the transducer within the patient's blood vessel without using a motor.

  The translation element 142 can include a cradle 148 that can be configured to mate with the mediating element 140 and a pedestal 149 that is translationally coupled to the cradle 148. In some embodiments, cradle 148 can translate with respect to pedestal 149 along track 150. In some such embodiments, when the catheter 102 is coupled to the mediating element 140 and the mediating element 140 mates with the cradle 148, the translation element 142 translates the cradle 148 along the track 150, thereby The transducer carried by 102 can be translated in any desired manner. The cradle 148 of FIG. 4B is shown in two possible positions: a distal position 154 indicated by a solid line and a proximal position 152 indicated by a broken line. In many embodiments, the translation element 142 can translate the cradle 148 from the distal position 154 to the proximal position 152 in a pullback operation. It should be understood that during some intravascular imaging operations, the translation element 142 translates in either direction between the distal position 154 and the proximal position 152 and / or between along the track 150. Can be configured to stop somewhere.

  According to some embodiments, in addition to the cradle 148 and pedestal 149 of the translation element 142, the mediating element 140 can function to support the reference element 124 and the movable element 126 of the position sensor 122. For example, in some embodiments, such as those shown in FIGS. 4A and 4B, the reference element 124 can be fixed to a point on the pedestal 149 of the translation element 142 while the movable element 126 is secured to the translation element 142. The cradle 148 can be fixed. In such an embodiment, the position sensor 122 can measure the relative position and movement between the cradle 148 and the pedestal 149. The mediating element 140 can be secured to the catheter 102 and cradle 148 such that when the cradle 148 is translated along the track 150, the transducer is translated within the patient's body. When the pedestal 149 is stationary with respect to the patient, the relative movement between the cradle 148 and the pedestal 149 corresponds to the relative movement of the transducer within the patient's body. In some embodiments, or the movable element 126 can be secured to the mediating element 140. Similarly, the relative movement between the mediating element 140 and the pedestal 149 can correspond to the relative movement of the transducer within the patient's body. Even if the movable element 126 is fixed to the pedestal 149 and the reference element 124 is fixed to the cradle 148 or the intermediate element 140, the relative movement between the movable element 126 and the reference element 124 is the same as in the above-described embodiment, and similarly You will see that it can be used.

  In some embodiments, for example, the reference element 124 can be positioned anywhere along the pedestal 149, including in or around the track 150. Similarly, the movable element 126 can be positioned anywhere along the cradle 148, including attachment means for securing the cradle 148 to the pedestal 149 along the track 150. In some embodiments, the reference element 124 and the movable element 126 are positioned so that they are closest to each other when the cradle 148 is in the most proximal position along the track 150. Alternatively, in some embodiments, the reference element 124 and the movable element 126 are closest to each other when the cradle 148 is in the most distal position along the track 150. As described above, the movable element 126 can be similarly positioned on the mediating element 140 and operated similarly. In some examples, the movable element 126 is positioned on the bottom surface of the mediating element 140, on the pedestal 149, and therefore as close as possible to the reference element 124 supported thereby.

  In some cases, the translation element 142 includes a groove 143 in which the anchor portion 103 of the catheter 102 can be secured. In some such embodiments, translation of the mediator element 140 translates the transducer within the catheter 102 while the anchor portion 103 keeps the rest of the catheter fixed. Become. Thus, for example, the reference element 124 can be positioned at or near the groove 143 of the pedestal 149 of the translation element 142 or the anchor portion 103 of the catheter 102 while the movable element 126 of the translation element 142 is Any portion that translates with respect to such a component, such as the cradle 148, the mediating element 140, or the translating portion of the catheter 102 itself may be located. In some embodiments, for example, the movable element 126 can be placed at or near the attachment point 156 between the catheter 102 and the mediating element 140. It will be appreciated that various such combinations of positions for the reference element 124 and the movable element 126 of the position sensor 122 are possible and within the scope of the present invention.

In some embodiments, the catheter 102 can include first and second telescopic portions that are configured to facilitate movement of the transducer 108 by expanding and contracting with respect to each other. The telescoping portion may be used, for example, with the anchor portion (103 in FIGS. 4A-4B) of the catheter 102 and the groove (143 in FIGS. 4A-4B) of the translation element (143 in FIGS. 4A-4B) to provide catheter 102 and transducer 108. Can be moved with respect to the stationary portion of the catheter 102 (eg, the anchor 103 of FIGS. 4A-4B). 5A and 5B are exemplary configurations of first and second telescoping portions 164, 166 as part of an intravascular imaging catheter 102 that can be used in an intravascular imaging system. FIG. 5A shows a first telescoping portion 164 and a second telescoping portion 166 as part of the intravascular imaging catheter 102. Although shown in the illustrated embodiment as part of the catheter 102, it will be appreciated that the telescoping portion may be external to the catheter in some systems. In the example shown in FIG. 5A, the first telescoping portion 164 goes into the opening in the second telescoping portion 166. The first and second telescopic parts 164, 166 can be slidably coupled so as to allow relative movement therebetween.

5B shows the first and second telescoping portions 164, 166 of the intravascular imaging catheter 102 of FIG. 5A, the first telescoping portion 164 extends from the second telescoping portion 166. In many embodiments, the first and second telescoping portions 164, 166 can be configured to transition freely between the states shown in FIGS. 5A and 5B. That is, the first and second telescoping portions 164, 166 can “stretch” relative to each other. In some embodiments, one of the first and second telescoping portions 164, 166 can be secured to a component that remains stationary with respect to the patient in the intravascular imaging system, eg, FIG. 4A. It is the translation element 142 of the translation mechanism 110 shown to -4B.

In some embodiments, the transducer 108 can be coupled to one of the first and second telescoping portions 164, 166 but not the other. In such a configuration, the telescoping portion that is not coupled to the transducer 108 can remain fixed while the other telescoping portion is moving relative thereto, thereby causing the transducer 108 to rest. Move with respect to nested parts . Therefore, the movement of the transducer 108 can be facilitated by the telescopic movement of the first and second telescoping portions 164, 166. In the illustrated embodiment, the transducer 108 is coupled to a first telescoping portion 164, while the second telescoping portion 166 is secured to a stationary component of the system 100. When movement of the transducer 108 occurs (manual translation, motorized translation, etc.), the first telescoping portion 164 can translate within the second telescoping portion 166. In some embodiments, the transducer 108 can be coupled to the second telescoping portion 166, while the first telescoping portion 164 is secured to the stationary component of the system 100. When the movement of the transducer 108 occurs (manual translation, motorized translation, etc.), the second telescoping portion 166 can translate around the first telescoping portion 164. In various configurations, the transducer 108 can be coupled to the first telescoping portion 164 or the second telescoping portion 166 via a drive cable. Alternatively, in some systems, the first telescoping portion 164 or the second telescoping portion 166 can be part of the drive cable itself.

In some embodiments, the relative movement of the first and second telescopic portions 164, 166 of the catheter 102 can be correlated with the movement of the transducer 108 within the patient's blood vessel. Thus, each of the movable element 126 and the reference element 124 of the position sensor 122 can be coupled to one of the first and second telescoping portions 164, 166. In the embodiment of FIGS. 5A-5B, the movable element 126 can be coupled to the first telescoping portion 164 while the reference element 124 can be coupled to the second telescoping portion 166. In this configuration, when the first telescoping portion 164 is coupled to the transducer 108 and the second telescoping portion 166 is stationary with respect to the patient, the movable element 126 and the reference element 124 of the position sensor 122 Relative to the relative movement of the first and second telescoping portions 164, 166 relative to each other and ultimately relative movement of the transducer 108 within the patient's body. In some embodiments, the movable element 126 can be coupled to the second telescoping portion 166, while the reference element 124 can be coupled to the first telescoping portion 164. In this configuration, when the second telescoping portion 166 is coupled to the transducer 108 and the first telescoping portion 164 is stationary with respect to the patient, the movable element 126 and the reference element 124 of the position sensor 122 are fixed. The relative movement corresponds to the relative movement of the first and second telescoping portions 164, 166 and the relative movement of the transducer 108 within the patient's body.

In addition to being installed in the translation mechanism or catheter telescopic part , the position sensor components can be placed in a variety of suitable locations within the intravascular imaging system. In some embodiments, one of the movable element and the reference element is coupled to the transducer in some way such that its position correlates with the position of the transducer (e.g., a translation mechanism intermediate element or first nested part) . On the other hand, when the other of the movable element and the reference element is fixed with respect to the patient (eg, via a translation element or a telescoping part of the translation mechanism), the position sensor's movable element and the reference element The relative movement between can correspond to the relative movement of the transducer in the patient's body. According to some configurations, the movable element can be placed on or near the transducer and / or drive cable, while the reference element can be placed on the catheter sheath in which the transducer and drive cable translate. .

In some embodiments, one or both of the movable element or reference element of the position sensor can be placed on a reference medical component. Referring to FIG. 1, in some embodiments, the reference medical component can include a surgical mat 119. In some configurations, the reference element can be placed in a reference medical component that remains substantially stationary with respect to the patient, while the movable element corresponds to that of the transducer 108 of the intravascular imaging system 100. Can be connected to any component having a position. For example, the reference element can be placed on the surgical mat 119 under the patient 118, while the movable element can be any of the associated telescoping parts , the mediating element of the translation mechanism 110, the catheter drive cable, or the transducer 108. Can also be connected. In any such configuration, the relative movement between the reference element and the movable element of the position sensor can correspond to the relative movement between the transducer 108 and the patient 118.

Several system configurations for position sensors have been described. Various combinations of the described configurations are also envisioned. For example, in some embodiments, the movable element of the position sensor can be coupled to the telescoping portion , which can be coupled to the transducer 108, while the reference element is kept stationary with respect to the patient 118. Connected to any of the components, such as a surgical mat 119, a complementary telescoping portion , a translation mechanism pedestal, or any other such object. In general, the movable element can be coupled to any component that generally translates with the transducer 108, while the reference element can be coupled to any component that remains stationary with respect to the patient 118. In some such exemplary embodiments, the relative position of the movable element and the reference element ultimately corresponds to the relative position of the transducer 108 within the patient's blood vessel. Intravascular imaging systems according to some embodiments can include an intravascular imaging engine 112, which is configured to receive image information from a catheter in addition to position information from a position sensor. The intravascular imaging engine 112 can generate a display based on the image information and the position information.

  Intravascular imaging systems such as those described above can be used to generate one or more displays based on the image and position information. FIG. 6 is a step flow diagram illustrating an overview of how one or more displays can be generated. After the catheter is inserted into the patient by the system operator, an intravascular imaging engine, such as those described herein, can receive commands that perform intravascular imaging functions (200). This command can include imaging function parameters and schedules. The user may instruct the intravascular imaging engine to perform an imaging function. The user can manually program the desired parameters for the imaging function.

  The intravascular imaging engine can initiate an ordered imaging function in the intravascular imaging catheter (202). This includes joining the catheter, sending control signals and / or power to the catheter, rotating the catheter and / or transducer within the catheter, or other initiating process to perform the imaging function. be able to. In some embodiments, any one or combination of initiation processes can be initiated manually via a user interface.

  After initiating the imaging function (202), the intravascular imaging engine may receive image information from the catheter based on the performed imaging function (204). The image information can be in the form of electrical or other signals from the catheter and / or transducer. In addition, the intravascular imaging engine may receive position information from the position sensor (206). As described above, the position information can include information regarding the relative position of the reference element and the movable element, which can correspond to the relative position of the transducer within the patient's body.

  After receiving the image information and position information, the intravascular imaging engine can generate a display based on the received information (208). The display can be presented on a display where the system user can view it. The generated display can include, for example, a longitudinal image and / or a transverse image corresponding to one transducer position within the patient's body. In some systems, the generated display can be generated in real time by the intravascular imaging engine and shown on the display as a live image. In some embodiments, the generated display may include a single snapshot of the patient's blood vessel cross-section triggered by the user, wherein the image and location information is one at a time. Captured for one transducer position. In some embodiments, various displays can be generated. In some systems, the user can select which display mode (eg, real time, snapshot, etc.) to use.

  Based on the received command (eg, step (200)) and memory, the intravascular imaging engine may determine whether more information should be acquired (210). In some embodiments, the user can determine whether more information is obtained. If acquired, the intravascular imaging engine may initiate translation of the transducer within the patient's body (212). For example, in some systems, a selection display mode selected by the user, such as a real time display or a snapshot display, can be used to determine whether more information should be obtained (210). In some embodiments, the intravascular imaging system includes a translation mechanism. The translation mechanism can be configured for automatic translation and / or manual operation via a motor. In some such embodiments, the imaging engine can interface with the translation mechanism and initiate translation directly via the motor (212). Some embodiments of the intravascular imaging system are configured for manual translation of the transducer. In such an embodiment, the intravascular imaging engine can prompt the user to translate the transducer. After the transducer has been translated, the imaging function can begin again (202) and the process is repeated. If it is determined not to obtain additional information (210), the generated display, image, and / or location information can be stored in memory (214). In some embodiments, the user can manually store the information in memory. Once all operations using the catheter are complete, in various embodiments, the catheter can be manually or automatically removed from the patient's body (214).

  The step of receiving image information (204) and the step of receiving position information (206) can also include receiving several sets of images and position information from several individual positions of the movable element of the position sensor. . In some embodiments, receiving image information (204) and receiving position information (206) comprises a first set of images and position information corresponding to a first position of a movable element of the position sensor; A step of receiving a second set of images and position information corresponding to a second position of the movable element of the position sensor can be included, wherein the first and second positions are distinguished from each other.

  In some embodiments, the position of the movable element of the position sensor is correlated with the position of the transducer in the patient's blood vessel, so that the received image and set of position information can correspond to different positions of the transducer. In some embodiments, at any one of the movable element positions for which image and position information is received, the image and position information can be correlated as received at a common transducer position. Each set of image information can correspond to image information generated from a unique location within the patient's blood vessel. A collection of location information can provide details regarding the spatial relationship between unique locations. Thus, a composite image can be configured by combining images and position information from a plurality of movable element positions.

  In some embodiments, the image and position information is received from a series of transducer positions by performing a pullback operation (over the entire region of interest of the patient's blood vessel). Pullback can include inserting a catheter into a patient's blood vessel and performing an imaging function while pulling the transducer back from the patient, whereby images and position information corresponding to multiple transducer positions are acquired. The Pullback can be performed by a motor and initiated by the user via the user interface of the intravascular imaging engine. A predetermined pullback operation can be performed, in which case the motor pulls the transducer back in a predetermined manner. In some embodiments, the user can manually control the operation of the motor and control the pullback operation. The motor controlled pullback can be performed automatically as part of an imaging schedule stored in memory. The automatic pullback can include a feedback element configured to provide position information from the position sensor to the intravascular imaging engine, and the intravascular imaging engine can control the motor based on the position information. In some configurations, pullback can be performed completely manually, in which case the user manually translates the transducer within the patient's body while performing the imaging function. By performing the bullback imaging operation, multiple sets of positions and corresponding image information can be obtained, in which the relative spatial relationships between the sets of position information are known.

  Images from multiple movable element positions (ie, transducer positions) and position information can be combined to generate a three-dimensional space of image information. If the received transducers and relative transducer positions for each set of image information are known, each set of image information can be placed in the correct order and with proper spatial separation. In some embodiments, one set of image data received by the intravascular imaging engine includes a cross-sectional image of a patient's blood vessel near the transducer. One set of position information may include the longitudinal relative position of the transducer within the patient's blood vessel. The second set of images and position information received from the second position can include a second transverse image and a relative longitudinal position of the transducer when the image was taken. The relative relationship between the first and second transducer positions can be determined by the first and second sets of position information. Thus, the first and second sets of image information can represent transverse images taken at major axis positions separated by a known distance. Cross-sectional images can be combined along the major axis at an appropriate distance to form a three-dimensional representation of the two sets of information.

  In general, any number of sets of images and position information (ie, unique cross-sectional images) can be combined in this manner to build a three-dimensional representation around the transducer, such as a patient's blood vessel. Such an expression can be called a longitudinal image. FIG. 7 illustrates an exemplary longitudinal image that can be constructed by an embodiment of the intravascular imaging system. FIG. 7 shows a display 220 as shown, for example, on the display 114 of FIG. Referring again to FIG. 7, the display 220 can include a cross-sectional image 224 configured to display a collection of image information 222 corresponding to a particular transducer position. The display 220 includes longitudinal images 226 that are each from a particular position of the transducer 108 and are configured to show a series of sets of image information arranged in the longitudinal direction in response to the associated position information. be able to. The longitudinal image 226 may have a major axis representing the direction of translation of the transducer within the patient. Accordingly, each data point along the horizontal axis of the longitudinal image 226 can be associated with a corresponding transverse image 225. In FIG. 7, the axis representing the movement of the transducer is shown to be a horizontal axis, but such characteristics may instead indicate a vertical axis or other orientation, and in some embodiments It will be appreciated that can generally be a major axis. In some embodiments, the longitudinal image 226 is basically a side view of a plurality of transverse images stacked on top of each other and arranged according to their relative positions. In some embodiments, each of the cross-sectional images can include a small amount of longitudinal information, which can be used to fill a gap between previous transducer locations that received the image information.

  The display 220 shown in FIG. 7 can include image data 228. The image data 228 may include various types of information related to the transverse image 224, the longitudinal profile 226 image 226, the imaged patient, other system information, and the like. In some embodiments, the image data 228 can include a patient's name, patient ID number, date and time, frame number, and / or image information acquisition parameters, such as an imaging period. In various embodiments, the image data 228 can be displayed in one place on the display 220 or can be displayed around. In the example of FIG. 7, the image data 228 is arranged at a plurality of positions. In some embodiments, the display 220 can include a real-time display while continuously performing one or more imaging functions. Display 220 may include a user interface 230 that provides commands and control functions to the user.

  In some embodiments, the display 220 shown in FIG. 7 is part of an intravascular imaging engine. Display 220 may include a touch screen for user input and operation. In some embodiments, the user can perform various functions related to the generated display 220. In some examples, the user adjusts the brightness and / or contrast of the display 220, saves a screenshot in memory, initiates an imaging function such as a pullback operation, and exits the imaging function. Others can be done. In the case of a longitudinal image 226, in some embodiments, the user can select a point along the major axis in the longitudinal image 226 to display the associated transverse image 224 of the corresponding transducer position.

  Referring back to FIG. 1, the method of using the intravascular imaging system 100 includes inserting the tip 106 of the catheter 102, including the transducer 108, into the blood vessel of the patient 118. A user 116 can initiate an imaging operation via the user interface 120 of the intravascular imaging engine 112, in which the transducer 108 provides image information to the intravascular imaging engine 112. The system 100 can include a position sensor that includes a reference element and a movable element, and can be configured such that the reference element is fixed with respect to the patient and the movable element position is correlated with the position of the transducer 108. Accordingly, the intravascular imaging engine 112 can receive position information from the position sensor. The intravascular imaging engine 112 can generate a display based on the received position and image information.

  The user 116 can initiate translation of the transducer 108 within the body of the patient 118 so that the intravascular imaging engine 112 receives images and position information regarding the movable element 126 and thus multiple positions of the transducer 108. The intravascular imaging engine 112 receives this information and can combine it into a composite image, such as the longitudinal image 226 of FIG. Referring back to FIG. 1, the user 116 can manipulate or save the display via the intravascular imaging engine 112. In some embodiments, the user can select a portion of the longitudinal image and display a corresponding cross-sectional image therefrom.

  Various aspects of the invention may be embodied in non-transitory computer readable media. The non-transitory computer readable medium may include executable instructions that cause the processor to receive image information from the transducer 108 near the tip 106 of the intravascular imaging catheter 102 and position information from the position sensor. The position sensor can include a movable element and a reference element, and the position information represents a position relative to the transducer position with respect to the position of the movable element. The non-transitory computer readable medium may further include executable instructions that cause the processor to generate a display based on the received image information and location information. In some embodiments, the non-transitory computer readable medium can be embodied in the intravascular imaging engine 112. In some embodiments, the non-transitory computer readable medium may include executable instructions that cause a processor to perform any of the methods described herein.

  It should be understood that components described in connection with a particular embodiment of the invention may be combined to form another embodiment. The instructions embodied or encoded in the computer readable storage medium may cause a programmable processor or other processor to execute the predetermined instructions. The computing readable storage medium may include random access memory (RAM), read only memory (ROM), hard disk, optical medium, or other computer readable medium.

  Various examples have been described. These and other examples are within the scope of the following claims.

Claims (22)

In the endovascular system,
(A) An intravascular imaging catheter including a proximal end, a distal end, a first telescopic part , and a second telescopic part , wherein the transducer is disposed at a transducer position near the distal end of the intravascular imaging catheter. Accordingly, the transducer is coupled to the first telescoping portion, and the first telescoping portion is configured to move within the second telescoping portion to move the transducer. An intravascular imaging catheter;
(B) a position sensor comprising a reference element positioned in front Stories second telescoping portion of the movable element catheter positioned in the first telescoping section of said catheter, said movable element, the transducer has a movable element position correlated with the position, a position sensor such as the position sensor is configured to measure the moving element position against the position of the reference element,
(C) an intravascular imaging engine coupled to the intravascular imaging catheter, receiving image information from the intravascular imaging catheter and position information from the position sensor, and based on the image information and the position information An intravascular imaging engine configured to generate the display;
Intravascular system including. The image information and the position information are:
A first set of image information and position information corresponding to the first movable element position;
A second set of image information and position information corresponding to a second movable element position different from the first movable element position;
The intravascular system according to claim 1, comprising:   The intravascular system of claim 1, wherein the intravascular imaging catheter comprises an IVUS imaging catheter.   The intravascular system of claim 1, further comprising a translation mechanism configured to cause translation of the transducer of the intravascular imaging catheter.   (E) a rotation mechanism joined to the proximal end of the intravascular imaging catheter and configured to rotate the intravascular imaging catheter, the rotation mechanism engaging the translation mechanism and the translation The intravascular system of claim 4 configured to be translated by a mechanism.   The intravascular system according to claim 4, wherein the translation mechanism is motorized for automatic translation.   The intravascular system of claim 4, wherein the translation mechanism includes an attenuation mechanism configured to facilitate smooth translation of the transducer of the intravascular imaging catheter.   The intravascular system according to claim 1, wherein the position sensor includes an electrometer.   The intravascular system according to claim 1, wherein the position sensor includes an encoder. To the programmable processor,
(A) receiving image information associated with a plurality of transducer positions from a transducer of an intravascular imaging catheter ;
( B) receiving position information associated with the plurality of transducer positions and corresponding to the received image information from a position sensor ;
(C) Ru to produce a display based on the received image information and position information,
A non-transitory computer-readable medium containing executable instructions for
The transducer is disposed near a distal end of the intravascular imaging catheter, the intravascular imaging catheter includes a first telescopic portion and a second telescopic portion, and the transducer is the first telescopic portion. And wherein the first telescoping portion is configured to move within the second telescoping portion to move the transducer;
The position sensor includes a movable element located in the first telescopic part of the intravascular imaging catheter and a reference element located in the second telescopic part of the intravascular imaging catheter, The information includes a movable element position relative to a reference element position and relative to the relative position of the first and second telescoping portions of the intravascular imaging catheter relative to each other and the position of the transducer of the catheter;
The display includes an IVUS longitudinal image based on the received image information and received position information, and a transverse image corresponding to the image information received at one of the plurality of transducer positions.
Non-transitory computer readable medium. The non-transitory computer readable medium of claim 10 , wherein receiving image information from the transducer of the intravascular imaging catheter comprises receiving image information from an ultrasound transducer of an IVUS catheter. The non-transitory computer readable medium of claim 11 , further comprising executable instructions to cause the programmable processor to (e) operate a motor to translate the transducer. The non-transitory computer readable medium of claim 10 , wherein receiving the position information includes receiving position information from an electrometer. The non-transitory computer-readable medium of claim 10 , wherein receiving the position information includes receiving position information from an encoder.   The blood vessel of claim 6, wherein the intravascular imaging engine is configured to instruct the translation mechanism to translate the transducer by a predetermined amount based on feedback position information received from the position sensor. Inside system. The executable instructions for causing the programmable processor to operate the motor and translate the transducer include translating the transducer by a predetermined amount to the motor using the received position information. non-transitory computer readable medium according to 12.   The intravascular imaging engine includes a user interface configured to present the generated display to a user and receive input from the user, wherein the generated display is one longitudinal An IVUS transverse image including image information corresponding to the position and an IVUS longitudinal image including image data from a plurality of longitudinal positions, wherein the input includes selection of a certain longitudinal position from the IVUS longitudinal image. The endovascular system of claim 1, wherein the displayed IVUS cross-sectional image corresponds to the selected longitudinal position. The generated display includes both the received image information and an IVUS longitudinal image based on the received position information and a transverse image corresponding to the image information received at one of the plurality of transducer positions;
The instructions further cause the programmable processor to receive a selection of a position corresponding to one of the plurality of transducer positions in the IVUS longitudinal image,
The transverse image in the generated representation represents image data associated with the position selected from the IVUS longitudinal image;
The non-transitory computer readable medium of claim 10 . The transducer is coupled to the first telescoping portion of the catheter, and the movable element of the position sensor is located in the first telescoping portion of the catheter; The intravascular system of claim 1, wherein a reference element is located in the second telescopic portion of the catheter. The transducer is coupled to the second telescoping portion of the catheter, and the movable element of the position sensor is located in the second telescoping portion of the catheter; The intravascular system according to claim 1, wherein a reference element is located in the first telescopic portion of the catheter. The transducer is coupled to the first telescoping portion of the catheter, and the movable element of the position sensor is located in the first telescoping portion of the catheter; The non-transitory computer readable medium of claim 10 , wherein a reference element is located in the second telescopic portion of the catheter. The transducer is coupled to the second telescoping portion of the catheter, and the movable element of the position sensor is located in the second telescoping portion of the catheter; The non-transitory computer readable medium of claim 10 , wherein a reference element is located in the first telescopic portion of the catheter.